Women’s risk for lung cancer on the rise

Smoking identified by research as driving force for increase

It’s well known that smoking is harmful to one’s health, but recent research gives new cause and urgency for concern: Women are catching up to men in their risk for lung cancers related to lighting up. For both men and women, lung cancer kills more than any other cancer, including breast and prostate.

Currently, more than 35 million Americans smoke. A landmark report published by the surgeon general in 1964 stated that smoking could cause lung cancer in men, but did little to address a woman’s risk as few had smoked long enough to produce evidence. Almost 50 years later, research published in the January issue of the New England Journal of Medicine evaluated modern rates of female smoking and uncovered startling facts, including that a woman smoker’s risk of lung cancer death is more than 25 times higher than those who never smoked, as well as that women are much less likely to quit smoking than men.

These are worrisome figures, particularly because lung cancer is notoriously caught late and thus difficult to treat – approximately 55 percent are diagnosed at stage 4 when the cancer has spread beyond the chest and is typically incurable. It’s important to note that the increasing smoking rates among women during the 20th century have been the main reason for the observed increase in female lung cancers in the current study. Because of longer life spans, women are also at risk for losing more life years due to smoking as compared to men. Fortunately, improvements in screening and treatment are being made all the time.

The single most important factor in the successful treatment of lung cancer is early detection. Symptoms may take years to appear, so high-risk patients can now be considered for annual CT screenings, which have been shown to significantly reduce deaths despite controversy over cost-effectiveness. This type of screening for appropriate patients is now supported by several national guidelines, although not yet routinely reimbursed by most insurance companies.

When lung cancer is detected early, there are several treatment options, including surgery and focal radiation. Surgery has been the historical standard for treatment; if cancer is diagnosed early, cure is possible by surgically removing the tumor and the nearby lymph nodes if necessary. Radiotherapy destroys tumors by focusing high-energy X-rays on cancer cells. It can also be used as a curative treatment for early-stage lung cancer, or in combination with chemotherapy for more advanced disease. Systemic therapies like chemotherapy are also used to extend survival and quality of life in late-stage lung cancer.

There have been tremendous advances in surgery, radiotherapy and anti-cancer drugs, including minimally invasive procedures, more targeted treatments like highly focused radiation therapy and drugs that specifically target cancer cells. Such advances have helped improve survival and/or quality of life in various stages of disease.

Of course, the old adage of prevention over treatment holds very true for lung cancer and begins with one of the most important decisions a person will make: the decision to quit smoking. We know with certainty that it is never too late to quit smoking, and that the benefits are huge and long-lasting. While the prevalence of lung cancer presents a challenge for society, there is hope for life beyond diagnosis.